Pancreatology

Pancreatology is a medical specialty dedicated to the study and treatment of diseases of the pancreas, an organ with both endocrine and exocrine functions. The field encompasses clinical care, diagnostic evaluation, surgical management, and research, drawing on gastroenterology, endocrinology, oncology, radiology, and surgery. Pancreatology covers healthy pancreas biology as well as disease processes affecting pancreatic tissue, ducts, and innervation, with attention to metabolic consequences such as diabetes arising from pancreatic disease.

Common conditions addressed include acute and chronic pancreatitis, pancreatic cancer, and pancreatic cystic lesions such as intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms. Pancreatic exocrine insufficiency results from chronic inflammation, pancreatitis, or congenital conditions, leading to malabsorption and nutritional deficiencies. Endocrine disorders related to the pancreas include diabetes mellitus, particularly pancreatogenic or type 3c diabetes, caused by pancreatic disease.

Diagnostic approaches employ laboratory testing and imaging, including serum lipase and amylase, fecal elastase, CT, MRI/MRCP, endoscopic ultrasound (EUS), and, when indicated, ERCP. Management combines medical therapy (pain control, nutrition, and diabetes management), pancreatic enzyme replacement therapy, endoscopic or surgical interventions for drainage or tumor resection, and multimodal cancer treatment when applicable. Palliative care and quality-of-life considerations are integral in advanced disease.

Research in pancreatology addresses early detection, cyst surveillance, genetic risks, and novel imaging biomarkers; precision medicine approaches; and optimization of multidisciplinary care models. Training for pancreatology typically involves gastroenterology or surgical specialties, followed by formal fellowships or focused expertise in pancreatic diseases to support collaborative patient care.